Objective: To investigate the current status of screen exposure among preschool children in Shanghai and its association with family screen environment, so as to provide a scientific basis for family screen management. Methods: Using a convenient sampling method, a total of 349 preschool children aged 4-6 years were selected from 36 kindergarten classes in Xuhui District and Pudong New Area in Shanghai during April to June in 2023. Demographic characteristics and family screen environment were surveyed through an online questionnaire. Screen exposure of children was assessed using a diary method, with parents recording the activities over a 7day period. Multiple Logistic regression analysis was employed to identify factors influencing childrens screen content. Results: The average daily screen exposure time for children was (61.2±40.2) minutes, with an average of (12.4±17.6) minutes spent on educational screen content, 80.8% predominantly watched noneducational screen content. The percentages of time spent on educational screen content for 4yearold boys, 4yearold girls, 5yearold boys, 5yearold girls, 6yearold boys, and 6yearold girls were 20.1%, 14.7%, 21.3%, 21.9%, 20.6%, and 26.9%, respectively. Multivariate Logistic regression showed that children aged 5yearold (OR=0.49, 95%CI=0.25-0.96) and 6yearold (OR=0.45, 95%CI=0.21-0.95) were negatively associated with more noneducational screen content (P<0.05). However, occasional (OR=2.02, 95%CI=1.09-3.75) and sometimes (OR=4.50, 95%CI=1.70-11.90) using electronic devices to calm young child when crying, as well as children using electronic devices without adult supervision (OR=1.81, 95%CI=1.01-3.24) were positively associated with more noneducational screen content (P<0.05). Conclusions Preschool children in Shanghai exhibit high exposure to noneducational screen content, and family screen environment and parentchild interaction are associated with noneducational screen exposure. Strategies for family screen management should be developed to regulate childrens screen exposure behaviors, allowing electronic devices to play a positive role in their developmental process.

OBJECTIVETo explore the pathologic features and prognosis of early and late onset severe preeclampsia.

METHODSAn observational study was conducted in 178 cases of severe preeclampsia collected during January 2010 to December 2014 from Haidian Maternal and Child Health Hospital.The cases were divided into two groups according to the onset of gestational age of the severe preeclampsia, with 54 cases of namely early onset (onset ≤ 34 weeks) and 124 cases of late onset (onset >34 weeks). Clinical characteristics of the patients, perinatal outcome and the pathologic characteristics of the placentas in each group were evaluated.

RESULTSDecidual vascular disease, placental infarction, abruptio placentae and placental villi dysplasia were seen in both groups. The incidence of placental villi dysplasia was the highest, followed by placental infarction. Incidence of severe decidual vascular disease of early and late onset severe decidual vascular disease were 16.7% (9/54) and 5.6% (7/124), respectively.Incidence of placental infarction of early and late onset severe preeclampsia were 48.1% (26/54) and 61.3% (76/124). Incidence of placental villi dysplasia of early and late onset severe preeclampsia were 79.6% (43/54) and 50.8% (63/124). Incidence of Severe decidual vascular disease, placental infarction and placental villi dysplasia were significantly different between early and late onset severe preeclampsia cases (P<0.05), while there was no difference in decidual vascular disease and placenta thrombi (P>0.05). Fetal survival rate of every group was 81.5% (44/54) and 93.5% (116/124). Incidence of fetal growth retardation was 55.6% (30/54) and 38.7% (48/124). The fetal survival rate and incidence of fetal growth retardation were different between two groups (P<0.05).

CONCLUSIONSThe incidence of decidual vascular disease and placental villi dysplasia in early onset severe preeclampsia is higher than those in late onset severe preeclampsia. Neonatal outcome and prognosis in early onset severe preeclampsia are worse than those in late onset severe preeclampsia.

Chorionic Villi ; pathology ; Female ; Fetus ; Gestational Age ; Humans ; Placenta ; pathology ; Placenta Diseases ; epidemiology ; pathology ; Pre-Eclampsia ; epidemiology ; pathology ; Pregnancy

Objective: To evaluate the comprehensive workplace health promotion intervention effects on workplace health promotion in 10 government agencies. Methods: A prospective self-controlled design was employed. Baseline evaluation and effectiveness evaluation were both conducted by questionnaire investigation. Results: The intervention results showed that most effectiveness indicators were significantly improved including health behaviors, psychosocial work environment, and health status. After the intervention, the prevalence of passive smoking and physical inactivity decreased from 70.3% and 38.7% to 44.1% and 30.5%, respectively. The scores of job control and social support at work increased by 0.30 and 0.05, respectively. The prevalence of good self-rated health and good mental health raised from 68.3% and 68.8% to 75.6% and 85.6%, respectively. However, the scores of job demand increased by 0.4. Furthermore, the prevalence of occupational stress increased significantly from 45.8% to 65.5%. Conclusion After implementing workplace health promotion, the physical and mental health of the staff have been promoted. However, the occupational stress of government officials still need to be improved.

Objective:To investigate the changes in N-terminal pro-B-type natriuretic peptide (NT-proBNP) and its role in predicting major adverse cardiac events (MACEs) in patients with end-stage heart failure (ESHF) before and after implanted a HeartCon left ventricular assist device (LVAD).Methods:The retrospective study included 30 ESHF patients [23 males and 7 females, aged 54.5 (40.8, 60.0) years], who were admitted to TEDA International Cardiovascular Disease Hospital from September 15, 2020 to June 20, 2023 to receive treatment with HeartCon LVAD implantation. Their clinical data were analyzed and NT-proBNP concentrations in their blood samples were measured preoperatively and during the follow-up period. Patients were followed regularly and MACEs, including cardiac death and rehospitalization for right heart failure, were recorded within 6 months of discharge; Logistic regression was used for prognostic analysis, and Receiver Operator Characteristic (ROC) curves were used to assess the adjunctive diagnostic value of NT-proBNP for poor prognosis in LVAD patients. The cut-off values for diagnosing poor prognosis by NT-proBNP were divided into two groups, and survival analysis was performed by Kaplan-Meier and tested by log rank; Cox regression was performed to analyze whether high levels of NT-proBNP at 6 months of follow-up wsa a risk factor for poor prognosis in patients with LVAD.Results:The median preoperative NT-proBNP level in 30 ESHF patients successfully implanted with HeartCon LVADs was 3 251.0 (1 544.5, 6 401.5) pg/ml. It decreased significantly 7 days postoperatively (3 251.0 vs. 1 815.0 pg/ml, P<0.05), and then the decreasing trend slowed. It decreased to 1 182.0 (620.0, 3 385.3) pg/ml on the 90th post-operative day. The preoperative NT-proBNP>3 251.0 pg/ml group had a longer postoperative hospital stay (47 d vs 33 d, Z=-2.138, P=0.032). Multivariate logistic regression analysis, only NT-proBNP at 7 days postoperatively was found to predict poor prognosis in LVAD patients, with an OR of 1.001 ( P=0.01); ROC curves were analyzed for the adjunctive diagnostic value of 7-day postoperative NT-proBNP levels for poor prognosis (cut-off value of 2 083.0 pg/ml), with an AUC of 0.833 ( P=0.002); The Kaplan-Meier survival analysis showed that the time to MACEs within 6 months was significantly shorter in the group with NT-proBNP>2 083.0 pg/mL on postoperative day 7 than in the group with NT-proBNP≤2 083.0 pg/ml (3.538±0.689 vs. 5.471±0.323 months, P=0.004); Cox regression analysis showed that the risk of MACEs was 4.25 times higher in the 7-day postoperative NT-proBNP>2 083.0 pg/ml group than in the NT-proBNP≤2 083.0 pg/ml group ( HR=4.25, P=0.035). Conclusions:The higher the preoperative NT-proBNP level, the longer the postoperative hospital stay in HeartCon LVAD patients. NT-proBNP levels decrease most significantly on postoperative day 7 and is a risk factor for MACEs. It may be used as a prognostic predictor in ESHF patients with implanted LVADs.

Background Unhealthy lifestyles may constitute significant risk factors for dyslipidemia. However, limited studies focus on the association mentioned above among railway workers undertaking frequent shift work. Objective To understand the status of dyslipidemia and lifestyles among railway workers, and to investigate the association between the lifestyles of workers involved in different shift work schedules and dyslipidemia, aiming to provide a reference for the development of targeted intervention strategies against dyslipidemia in this occupational group. Methods The participants were selected from the in-service staff of a railway unit in 2021. A quota sampling approach was used to ensure the participation of at least 50% of employees from each department. Demographic and lifestyle information of the railway workers in 2021 was collected through self-administered questionnaires, while physiological and biochemical indicators were obtained through health examinations. Chi-square tests were employed to analyze the distribution of dyslipidemia among railway workers with different characteristics. Binary logistic regression was utilized to examine the associations between selected variables and dyslipidemia, and additive model was used to investigate the interaction between lifestyle and different shift work schedules on dyslipidemia. Results A total of 17392 railway workers were included in the study, and the total prevalence of dyslipidemia was 31.3%, with a higher prevalence reported among workers undertaking rotating night shifts (33.5%) and permanent night shifts (34.3%) than those with regular day work. The main adverse lifestyles among the railway workers were physical inactivity (59.6%), alcohol consumption (40.0%), and smoking (35.7%), and only 13.6% reported a healthy lifestyle. Furthermore, significant statistical differences in the prevalence of dyslipidemia were reported among workers with different lifestyles (P<0.01). After adjusting for confounding factors, smoking was a risk factor for dyslipidemia (OR=1.61, 95%CI: 1.48, 1.75), while highly active physical activity served as a protective factor against dyslipidemia (OR=0.79, 95%CI: 0.71, 0.88). In general, adopting a healthy lifestyle was associated with a decreased risk of dyslipidemia (OR=0.86, 95%CI: 0.77, 0.95). The stratified analyses based on different shift work schedules revealed a statistically significant association between smoking and dyslipidemia across various shift work occupational groups (P<0.001): regular day work, OR=1.62, 95%CI: 1.42, 1.84; rotating night shifts, OR=1.54, 95%CI: 1.35, 1.76; and permanent night shifts, OR=1.75, 95%CI: 1.40, 2.18. In regular day workers, highly active physical activity was associated with a reduced risk of dyslipidemia (OR=0.81, 95%CI: 0.69, 0.95). A similar association was observed among workers undertaking rotating night shifts (OR=0.78, 95%CI: 0.65, 0.94); furthermore, moderately active physical activity was also associated with a reduced risk of dyslipidemia in this occupational group (OR=0.85, 95%CI: 0.74, 0.97). There was no additive interaction between rotating night shifts and lifestyle with relative excess risk due to interaction (RERI), attributable proportion due to interaction (AP), and synergy index (S) of 0.18 (95%CI: −0.04, 0.41), 0.15 (95%CI: −0.04, 0.33), and 3.19 (95%CI: 0.09~110.44), respectively. There was also no additive interaction between permanent night shifts and lifestyle, with RERI, AP and S of −0.03 (95%CI: −0.43~0.37), −0.02 (95%CI: −0.35~0.31) and 0.90 (95%CI: 0.18~4.46). Further stratification of populations according to shift work schedules and lifestyles revealed that those who worked rotating night shifts and reported unhealthy lifestyles were more likely to present dyslipidemia than those who undertook regular day work and had healthy lifestyles (OR=1.27, 95%CI: 1.09, 1.48). Conclusion Railway workers present less optimistic lipid health status, and unhealthy lifestyles are prevalent among them. Those engaged in night shift work report a higher prevalence of dyslipidemia. Among workers with different shift schedules, smoking and physical inactivity are identified as the primary risk factors for dyslipidemia, and particular attention should be paid to the lipid health status of rotating night shift workers with poor lifestyles.

ObjectiveTo explore and analyze the influencing factors of myopia among the primary and middle school students, and to provide an evidence for the prevention and control of myopia in students through the combination of scientific use in electronic products and adherence improvement to outdoor activities. MethodsStratified cluster sampling method was used to select 4 schools in Jiading District, in which all the students in grades 3‒5 of primary school and grades 7‒9 of middle school were enrolled into the study for a questionnaire survey and refraction examination. The χ² test was used to compare the data between the myopic and non-myopic group. Logistic regression analysis was used to analyze the influencing factors of myopia. ResultsThe total myopia detection rate among the primary and middle school students in the industrial zone of Jiading District was 62.8%, with a detection rate of 46.9% for primary school students and 75.6% for middle school students, respectively. Logistic regression analysis showed that middle school (OR=3.639, 95%CI=3.045‒4.349, P<0.001), female students (OR=1.278, 95%CI=1.081‒1.510, P=0.004), the frequency of school desks and chairs was adjusted>1 semester (OR=1.227, 95%CI=1.031‒1.461, P=0.021), the length of time spent on extracurricular tutorial classes for main courses ≥1 hour in a week (OR=1.205,95%CI=1.009‒1.440, P=0.040), parents reduced the length of time that their children spent on exercise (OR=1.205, 95%CI=1.009‒1.440, P=0.040), and parental myopia (OR=2.611, 95%CI=2.157‒3.160, P<0.001) were associated with myopia among the primary and middle school students in the industrial zone of Jiading District. ConclusionThe detection rate of myopia among students in Jiading District was relatively high. More attention should be paid to the effect of school desks and chairs’ adjustment frequency, the length of time spent on extracurricular tutorial classes for main courses, electronic screen exposure time on students’ vision, so as to prevent and slow down the occurrence and development of myopia.

OBJECTIVE：To est ablish the working mode of the first pharmaceutical ward rounds of clinical pharmacists in our hospital，in order to provide a useful reference for establishing a national standardized pharmaceutical ward rounds model. METHODS：By sharing the clinical cases of the first pharmaceutical ward rounds ，the work content and process of the first pharmaceutical ward rounds in our hospital were introduced. RESULTS & CONCLUSIONS ：The clinical pharmacist ’s first pharmaceutical ward round in our hospital mainly includes self introduction of clinical pharmacists ，diagnosis of patients ’condition under the guidance of doctors ，collection and evaluation of patients ’previous medication information （including previous medication varieties ，usage methods ，efficacy and safety evaluation ），assistance for doctors in formulating initial treatment plan ， carrying out initial medication and diet education ，and intensive communication and cooperation with nurses. The development of first pharmaceutical ward rounds promotes the rational use of drugs in clinic ，elevates the hospitalization satisfaction of patients and improves the professional quality of clinical pharmacists.